Globally, the suicide rate has fallen by 38% from its peak in 1994. As a result, over four million lives have been saved – more than four times as many people as were killed in combat over the same period.

The decline has happened at different rates and different times in different parts of the world. For example:

• In the West, it started long ago:
  • In the UK, the male rate peaked at around 30 per 100,000 a year in 1905, and again at the same level in 1934, during the Great Depression; among women it peaked at 12 in 1964.
  • In most of the West, it has been flat or falling for the past two decades.
• In the East:
  • China’s started to come down in the 1990s and declined steadily, flattening out in recent years.
  • Although still high in Russia, South Korea and India, they have all fallen.
• The exception:
  • The big exception is the United States of America (USA).
  • Until the turn of the century the rate was dropping.
  • But has since risen by 18% to 12.8; China is 7%.

Country-Specifics

In general, men are more likely to kill themselves than women, with China and India being historical exceptions. For example, among Chinese women in their 20s, the rate has dropped by nine-tenths since the mid-1990s. This group accounts for around half a million of those four million lives saved. It has been suggested that greater social freedoms account for the decrease in suicide rates among Chinese and Indian women.

Social bonds sometimes constrain people as well as sustaining them; escaping an abusive husband or tyrannical mother-in law is easier in a city than in a village. And, the means to kill oneself are harder to come by in a town than in the countryside.

In Russia, it is middle-aged men who dis-proportionally kill themselves. They, it seemed, were the victims of the huge social dislocation that happened after the collapse of the Soviet Union. Hyperinflation, falling incomes and rampant unemployment in the first years of transition left many facing misery and want. A financial crisis in 1998 wiped out many families’ savings. Although the trend reversed in the 2000s, Russia’s suicide rate is still high at 25 (it was around 50).

In the USA, suicide rates have risen fastest among white Americans than other groups (except for Native Americans). Although the increase in the USA suicide rate predated the economic crash, it accelerated in the recession that followed it.

Wet versus Dry Drinking

Alcohol also plays a part in suicide rates.

More so in countries with a ‘dry’ drinking culture, where people drink to get drunk, such as Russia, eastern Europe and Scandinavia. For example, in Russia drinking and suicide have risen and fallen in tandem.

This is in contrast to the ‘wet’ drinking cultures, where people drink socially over a meal, such those in southern and central Europe.

Suicide and drinking do seem to go together, but both might be the effect of social turbulence.

Research

Research suggests that, globally, people in rural areas are more likely to commit suicide that those in urban areas (aka towns and cities). Research also suggests that the USA, Canada, and Europe witnessed more than 10,000 more deaths between 2007 and 2010 due to the global economic crisis.

However, on a positive note, research suggests that government policy can mitigate the effects of recession. For example, Sweden witnessed no increase in its suicide rate between 1991-92 or after 2007. A study of 26 European countries showed suicide rates to be inversely correlated with spending on active labour-market policies.

Other government policies such as regulations on alcohol production, distribution and pricing can also reduce suicide rates.

At the global level, suicide is more common among older people than the young or middle-aged. However, the rate has been falling due, it has been suggested, to falling poverty rates, better palliative care, and improved home care.

Suicide is, generally considered, an impulsive act.

In a 1978 study of 515 people who had survived leaping from the Golden Gate Bridge, in the USA, between 1937 and 1971, 94% were still alive in 1978. During the 1960s, the UK switched from toxic coal gas (the favoured means of suicide among women and elderly men) to harmless North Sea gas, rates among those groups crashed. In another UK example, a law was passed in 1998 limiting the number of aspirin and paracetamol that could be sold in a single pack. In 1999, aspirin suicides were down by 46% and paracetamol ones by 22%.

Countries also frequently use blister packs – meaning each tablet must be removed individually. In contrast, the USA allows the sale of loose tablets in bottles, with up to 50 tablets per bottle. However, the preferred method in the USA is by gun – accounting for half of all suicides (the USA also happens to have more guns than people).

Therefore, limiting or removing the means can decrease the suicide rate.

What is the Werther Effect?

Named after the rash of suicides that followed the publication in 1774 of a novel by Goethe which ends with the eponymous hero’s suicide. It is particularly common in Asia, although the phenomenon has been observed all over the world.

For example, after Robin Williams, an American comedian, hanged himself in 2014, researchers calculated that there were 1,841 more suicides (10% increase) than would have been expected during the next four months. The rise in hangings, and among the middle aged, was particularly marked.

A number of countries have media guidelines concerning the reporting of suicides. There are a variety of examples of copy-cat suicides as a result of media reporting.

Socioeconomic Hypothesis

There is a socioeconomic hypothesis that the less well-off (e.g. those in poverty or unemployed) are more likely to contemplate suicide, especially men. Unemployed people kill themselves at a rate 2.5 times higher than those in work.

Summary

To reduce suicide rates what can we do?

• Limit or remove the means of committing suicide.
• Reduce the effects of recessions through social policies.
• Reduce the availability of alcohol, perhaps through pricing or cultural perceptions of drinking.
• Reduce the availability of guns.
• Increase social freedoms.
• Avoid reporting suicides in the media.